The renal diseases therapy area encompasses a range of diseases of the kidney, such as chronic kidney disease (CKD), acute kidney injury, diabetic nephropathy and focal segmental glomerulosclerosis. Renal diseases are becoming increasingly common due to the increased prevalence of hypertension and diabetes, two major causes of CKD. For most forms of renal diseases, early detection and management may slow down or prevent progression to renal failure and associated complications. However, many renal diseases are typically asymptomatic until they have progressed to end-stage renal disease (ESRD), which requires renal replacement therapies such as hemodialysis and renal transplantation, and is associated with substantial morbidity and mortality.

The first-in-class programs identified show considerable diversity, and the relatively high degree of innovation in the renal diseases therapy area makes for a promising development pipeline. It is clear that recent activity in this area has increased, partly owing to the growing recognition of the unmet medical need. Further investment in innovation would benefit the therapy area greatly, and likely prove a worthwhile investment, particularly for highly prevalent diseases such as CKD and diabetic nephropathy, for which there are a lack of effective pharmacotherapeutic options.

Scope
• With 365 products in active development, the pipeline is modestly sized. Does current pipeline innovation hold the potential to affect the future renal diseases market?
• There are 100 first-in-class products in the renal diseases pipeline. Which of these hold the greatest potential to improve future disease treatment with regard to their molecular target?
• The majority of first-in-class products were in development for indications involving inflammation. Which first-in-class targets are most promising, and how does the ratio of first-in-class targets to first-in-class products differ by stage of development and molecular target class?
• A significant number of first-in-class products have been identified with no prior involvement in deals. How do deal frequency and value compare between target families and molecule types, and which first-in-class programs have not yet been involved in a licensing or co-development deal?

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